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YOUR BROWSER'S BACK BUTTON ABOVE TO RETURN TO THE LAST PAGE VIEWEDFaxable Order FormFax this to1-717-664-2884

Company Name:

Contact Name:

Shipping Address:

City:

St.

Zip:

Phone:

Fax:

Email Address:

Part Number

Description

Qty.

Color

Size

Price

Item Total

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CREDIT CARD INFORMATION

Credit Card #

Amer Ex__ MC __
Visa __ Discover __

Name on Card

Exp Date:

3-Digit Security Code:------(Back of Card)

Card Address

YOU MUST TO SUPPLY YOUR STATES DEALER TAX NUMBER OR DIN #WHEN
PLACING YOUR ORDER.

State Dealer Number

State Sales Tax #

PRICES SUBJECT TO CHANGE
WITHOUT NOTICE - CURRENT PRICE CHANGES MAY NOT BE UPLOADED AT THIS TIME
Important
Notice !NO RETAIL SALES
This is a licensed dealer site only. All returns will carry a 30 % restock
fee + return shipping fees,if the order was returned due to customer
error or change of mind. All items must be returned within 30 days of
date of sale. After that time period expires, All sales are final. If
a return was necessary due to a shipping error on our part, we will
waive the restocking and shipping charges.